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Gonadorelin
Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Drug Interactions
Stability
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Monitoring Parameters
Mental Health: Effects on Mental Status
Mental Health: Effects on Psychiatric Treatment
Patient Information
Nursing Implications
Dosage Forms
References

Pronunciation
(goe nad oh REL in)

U.S. Brand Names
Factrel®; Lutrepulse®

Generic Available

No


Synonyms
GnRH; Gonadorelin Acetate; Gonadorelin Hydrochloride; Gonadotropin Releasing Hormone; LH-RH; LRH; Luteinizing Hormone Releasing Hormone

Pharmacological Index

Diagnostic Agent, Gonadotrophic Hormone; Gonadotropin


Use

Evaluation of the functional capacity and response of gonadotrophic hormones; evaluate abnormal gonadotropin regulation as in precocious puberty and delayed puberty. Lutrepulse®: Induction of ovulation in females with hypothalamic amenorrhea.


Pregnancy Risk Factor

B


Contraindications

Known hypersensitivity to gonadorelin, women with any condition that could be exacerbated by pregnancy; patients who have ovarian cysts or causes of anovulation other than those of hypothalamic origin; any condition that may worsened by reproductive hormones


Warnings/Precautions

Hypersensitivity and anaphylactic reactions have occurred following multiple-dose administration; multiple pregnancy is a possibility; use with caution in women in whom pregnancy could worsen pre-existing conditions (eg, pituitary prolactinemia). Multiple pregnancy is a possibility with Lutrepulse®.


Adverse Reactions

1% to 10%: Local: Pain at injection site

<1%: Flushing, lightheadedness, headache, rash, nausea, abdominal discomfort


Overdosage/Toxicology

Symptoms of overdose include abdominal discomfort, nausea, headache, flushing

Treatment is symptomatic


Drug Interactions

Decreased levels/effect: Oral contraceptives, digoxin, phenothiazines, dopamine antagonists

Increased levels/effect: Androgens, estrogens, progestins, glucocorticoids, spironolactone, levodopa


Stability

Factrel®: Prepare immediately prior to use; after reconstitution, store at room temperature and use within 1 day; discard unused portion

Lutrepulse®: Store at room temperature; reconstitute with diluent immediately prior to use and transfer to plastic reservoir. The solution will supply 90 minute pulsatile doses for 7 consecutive days (Lutrepulse® pump).


Mechanism of Action

Stimulates the release of luteinizing hormone (LH) from the anterior pituitary gland


Pharmacodynamics/Kinetics

Peak effect: Maximal LH release occurs within 20 minutes

Duration of action: 3-5 hours

Half-life: 4 minutes


Usual Dosage

Diagnostic test: Children >12 years and Adults (female): I.V., S.C. hydrochloride salt: 100 mcg administered in women during early phase of menstrual cycle (day 1-7)

Primary hypothalamic amenorrhea: Female adults: Acetate: I.V.: 5 mcg every 90 minutes via Lutrepulse® pump kit at treatment intervals of 21 days (pump will pulsate every 90 minutes for 7 days)


Monitoring Parameters

LH, FSH


Mental Health: Effects on Mental Status

None reported


Mental Health: Effects on Psychiatric Treatment

Antipsychotics may decrease the effects of gonadorelin


Patient Information

If receiving this drug via pulsating pump, check all procedures with prescriber. Report any rash, pain, or inflammation at injection site, and any change in respiratory status.


Nursing Implications

Parenteral: Dilute in 3 mL of normal saline; administer I.V. push over 30 seconds


Dosage Forms

Injection, as acetate (Lutrepulse®): 0.8 mg, 3.2 mg

Injection, as hydrochloride (Factrel®): 100 mcg, 500 mcg


References

Pescovitz OH, Comite F, Hench K, et al, "The NIH Experience With Precocious Puberty: Diagnostic Subgroups and Response to Short-Term Luteinizing Hormone-Releasing Hormone Analogue Therapy," J Pediatr, 1986, 108(1):47-54.


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